Anti-depressants by the pound

Imagine this scenario. Your therapist is writing a prescription for an antidepressant. She asks you, "Which would you prefer? An antidepressant that doesn't work very well but will not cause you to gain weight or one that will take away your depression, anxiety, and panic attacks but leave you 30 pounds heavier?"

This may be imaginary but the problem is real. Most antidepressants that are effective in restoring emotional stability and well being have a distressing side effect. They may cause you to gain between 5 and 30 + pounds within the first year of taking them. And if you are given the medication classed as mood stabilizers, the weight gain may be much more. Unfortunately, the one antidepressant which may be without weight gain potential is often not the first prescribed, as it may not be as effective as the others.

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When I was running a weight-loss center for a university-affiliated psychiatric hospital, our clients all seemed to tell the same story. They were at a normal weight before starting on their treatment for mood disorders, never had to diet and exercised routinely. But treatment with antidepressants, mood stabilizers and antipsychotic medications changed them into obese individuals who could not control their eating. They also felt too fat, in their own words, to exercise anymore.

"Would you believe that I used to be a competitive tennis player?" one of our clients asked. "I gained 50 pounds on my meds and now I can barely bend over to pick up a tennis ball."

When we questioned clients about how their eating had changed, they all said that the feeling of satisfaction after eating had disappeared and they were left with a nagging feeling that they had to continue eating. "My stomach might be bulging but I keep stuffing food in my mouth," was a typical response.

Fortunately, and somewhat accidentally, we developed a weight-loss program for our clients that worked. It was accidental because we used the program we had already developed for people who had gained weight the traditional way. It was based on increasing satiety, or the sense of having eaten enough, by boosting the brain chemical serotonin. Not knowing why the medications caused overeating left us with only one option: to stop the eating before too many calories were consumed. Research that we and others had conducted told us that serotonin was involved in getting animals and people to stop eating. Our plan was simple. Our clients were told to either consume a therapeutic amount of carbohydrate in a beverage we had developed or by eat carbohydrate snacks. The carbohydrate would lead to an increase in serotonin, which, we hoped, would turn off appetite. It did, and our clients lost weight.

One day soon we hope there will be medications for mood disorders that do not cause substantial weight gain. But until that happens, we believe that patients do not have to pay for their relief from depression in pounds. Patients do not have to gain weight. It is not inevitable. As we advise in our book, The Serotonin Power Diet, simply incorporating high carbohydrate, low-protein snacks into a daily food plan is enough to boost serotonin. And then this amazing brain chemical will do the rest.